Facial anatomy holds tissue in place through a network of ligaments that anchor skin and fat to underlying bone. As those ligaments loosen with age, tissue descends, producing the sagging that facelifts aim to correct. Dr. Andrew Jacono’s extended deep-plane technique addresses this directly, releasing four key ligaments rather than relying on skin tension to fight the effects of that descent.

Working With the Face’s Structure

Conventional facelifts leave these ligaments largely intact and instead pull the skin above them upward and back, a method that tightens the surface without changing what is happening underneath. Dr. Andrew Jacono‘s approach releases the ligaments themselves, which frees descended fat pads in the midface, jawline, and neck to be repositioned along a vertical vector that more closely matches how a younger face is naturally supported. Town & Country summarized the resulting philosophy simply, describing how Jacono keeps the skin, muscle, and fat as one unit instead of separating them into layers that move independently during the lift.

Clinical Consequences of Deeper Dissection

Working at this depth requires more precision than a superficial lift, since the dissection travels closer to the facial nerve. Research following Dr. Andrew Jacono’s original 2011 publication in the Aesthetic Surgery Journal, which documented outcomes in 153 patients, has shown that deep-plane techniques actually cause facial nerve injury less often than superficial approaches, because the dissection preserves anatomical relationships and blood supply more effectively. Initial data on his technique recorded a temporary facial nerve injury rate of just 1.3 percent.

Jacono has continued refining ligament release and repositioning through a 2019 update focused on the jawline, and he now performs roughly 250 of these procedures annually. That volume has given him detailed familiarity with how facial ligaments vary between patients, knowledge reflected in his 2021 textbook drawing on more than 2,000 facelift cases and now taught to other surgeons at the more than 100 international conferences where he has delivered master lectures. Read this article for additional information.

Follow for more about Dr. Andrew Jacono on https://www.facebook.com/DrJacono/